<div class="row">
    <div class="col-xs-12">
        <div class="panel panel-midnightblue">
            <div class="panel-body">
                <form action="" class="form-horizontal row-border"  data-validate="parsley" id="validate-form">
                	<div class="row">
                		 <div class="form-group">
                    		<label class="col-sm-3 control-label" >课程名称:</label>
                    		<div class="col-sm-6">
                    			<input type="text"   readonly  name="course_name" value="{$pt_order.course_name}" class="form-control" id="course_name" />
                    		</div>
                   		 </div>
                   		 <div class="form-group">
                   		 	<label class="col-sm-3 control-label">预约pt</label>
                   		 	<div class="col-sm-6">
                    			<select class="form-control" disabled="disabled">
                    				{foreach name="ptlist" item="v"}
                    					<option  {eq name="$pt_follow.pt_id" value="$v.id"} selected {/eq} value="{$v.id}">{$v.name}</option>
                    				{/foreach}
                    			</select>
                    		</div>
                   		 </div>
                   		 
                   		<div class="form-group">
                    		<label class="col-sm-3 control-label" >上课pt:</label>
                    		<div class="col-sm-6">
                    			<select class="form-control" name="pt_id">
                    				{foreach name="ptlist" item="v"}
                    					<option  {eq name="$pt_follow.pt_id" value="$v.id"} selected {/eq} value="{$v.id}">{$v.name}</option>
                    				{/foreach}
                    			</select>
                    		</div>
                   		</div>
                   		
                   		<div class="form-group">
                   			<label class="col-sm-3 control-label">上课课时</label>
                   			<div class="col-sm-6">
                   				<input class="form-control" type="text" readonly="readonly" name="course_count" id="course_count" data-min="0" data-max="{$pt_follow.course_count}" value="{$pt_follow.course_count}" data-type="number" />
                   			</div>
                   		</div>
                   		
                   		<div class="form-group">
                   			<label class="col-sm-3 control-label">上课时间</label>
                   			<div class="col-sm-6">
                   				<input class="form-control" readonly type="text" name="up_time" id="up_time" required="required" value="<?php echo date('Y-m-d H:i:s') ?>" />
                   			</div>
                   		</div>
                   		
                   		<input type="hidden" name="member_id" value="{$member.id}" />
                   		<input type="hidden" name="pt_order_id" value="{$pt_order.id}" />
                   		<input type="hidden" name="pt_follow_id" id="pt_follow_id" value="{$pt_follow.id}" />
                   		<input type="hidden" name="shop_id" id="shop_id" value="{$member.shop_id}" />
                   		<input type="hidden" name="surplus" id="surplus" value="{$pt_order.surplus}" />
                	</div>
                </form>
            </div>
            <div class="panel-footer">
                <div class="row">
                    <div class="col-sm-6 col-sm-offset-3">
                        <div class="btn-toolbar">
                            <button class="btn-primary btn" id="form-submit">提交</button>
                            <button class="btn-default btn" data-dismiss="modal">关闭</button>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>
<script type='text/javascript' src='{$Think.GYM_VIEW_JS}subscribe/up.js'></script>